Advertisement

The Surgical Management of Bilateral Carotid Artery Occlusive Disease

  • Stephen C. Boone

Abstract

Fifty percent of our patients undergoing EC-IC bypass surgery have been found to have.bilateral carotid artery occlusive disease. The purpose of this paper is to analyze this small number of patients to see if a logical sequence of surgical therapy can be arrived at. A similar series of patients was reported by Moran et al.4 It was their recommendation that in patients with a symptomatic unilateral carotid occlusion and a contralateral carotid stenosis a STA-MCA bypass should be done first on the occluded side. Then a prophylactic carotid endarterectomy could be performed on the other side. Some surgeons might disagree with this sequence by arguing that a carotid endarterectomy done first might alleviate the symptoms on the occluded side, via collateral flow through the anterior communicating artery. If this were the case, then only one operation would be necessary, i.e., the ischemic symptoms on the occluded side would be alleviated and the brain on the stenotic side would be prophylactically protected.

Keywords

Internal Carotid Artery Carotid Endarterectomy Carotid Stenosis Superficial Temporal Artery Carotid Artery Occlusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Andersen, C.A., Rich, N.M., Colins, G.J., McDonald, P.T., Boone, S.C. Unilateral internal carotid arterial occlusion: Special considerations. Stroke 8: 699–671, 1977.CrossRefGoogle Scholar
  2. 2.
    Fields, W.S., Lemak, N.A. Joint study of extra-cranial arterial occlusion. X. Internal carotid occlusion. JAMA 235: 2734–2738, 1976.PubMedCrossRefGoogle Scholar
  3. 3.
    Hass, W.K., Fields, W.S., North, R.R., Kricheff, I.I., Chase, N.E., Bauer, R.B. Joint study of extracranial arterial occlusion. JAMA 203: 961–968, 1968.PubMedCrossRefGoogle Scholar
  4. 4.
    Moran, J.M., Reichman, O.H., Baker, W.H. Staged intracranial and extracranial revascularization. Arch Surg 112: 1424–1428, 1977.PubMedGoogle Scholar
  5. 5.
    Patterson, R. H. Risk of carotid surgery with occlusion of the contralateral carotid artery. Arch Neurol 30: 188–189, 1974.PubMedGoogle Scholar
  6. 6.
    Thompson, J.E., Talkington, C.M. Carotid end-arterectomy. Ann Surg 184: 1–15, 1976.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1980

Authors and Affiliations

  • Stephen C. Boone

There are no affiliations available

Personalised recommendations